Introduction: Gingival overgrowth (GO) is the increase in the size of the gingiva due to various causes. The knowledge about their diverse clinical and histopathological features helps us in their diagnosis, treatment, and management. Aim and objective: To understand the clinical and the histopathological spectrum of inflammatory gingival overgrowth (IGO), drug-induced gingival overgrowth (DIGO), and hereditary gingival overgrowth (HGO). Settings and design: Ninety histopathologically diagnosed cases of IGO, DIGO, and HGO were studied. Materials and methods: 5 micron sections were stained with H & E. The clinical and the histopathological variables of epithelium and connective tissue were compared. Statistical analysis used: Chi-squared test was done to compare the variables among the groups. Results: The parameters, namely, age, site, color, consistency, shape, epithelium, rete ridges, inflammation, inflammatory cell predominance, vascularity, fibrosis, and hyalinization showed significant variation between the study groups. Conclusions: In this study, IGO, DIGO, and HGO showed a female predominance and most cases of IGO and HGO occurred in the 3rd–4th decade whereas DIGO in the 5th–6th decade. Clinically, IGO appeared erythematous and soft in consistency compared to DIGO and HGO, which appeared pink clinically and firm in consistency and all the three study groups showed a site predilection of the maxillary anterior region. Histopathologically IGO showed more inflammatory components than DIGO and HGO which showed more fibrotic connective tissues than IGO.
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